In Fukushima the number of children diagnosed with thyroid caner continues to rise.

The Fukushima Prefectural Health Management Survey—set up to examine the impact of radiation exposure from the Fukushima Daiichi nuclear accident—is being conducted on children who were aged 18 or younger when the accident occurred.

In the survey, children undergo ultrasound throat examinations, which look for such thyroid abnormalities as nodules and cysts. The results of these examinations are announced periodically.

On August 20, at a meeting of the Fukushima Prefectural Health Management Survey Review Committee in Fukushima city, an interim report was presented on the results of the survey during the year ended March 31, 2013. At the previous committee meeting in June, it was reported that 12 children had confirmed diagnosis of thyroid cancer. At the August 20 meeting, the number had risen by six, to 18 cases. What does this number actually mean? One of the lawyers acting for litigants in the Fukushima group evacuation lawsuit, Kenichi Ido, explains.

“The prevalence of child thyroid cancer is said to be one in one million. However, Fukushima has a population of around two million, and the current survey covers approximately 360,000 children. Just looking at these results, we can clearly see that the number of cases is much higher than should be expected. Would it not be reasonable to assume that some abnormal situation has occurred?

However, at the Review Committee meeting, Professor Shinichi Suzuki of Fukushima Medical University, which is leading the survey, said that a characteristic of thyroid cancer is that it develops slowly. Based on the size of the melanomas of those diagnosed with thyroid cancer, he stated, “I believe these (cancers) did not form within the last two or three years.” To date, the committee has consistently denied any linkage between the nuclear accident and the 18 confirmed child thyroid cancer cases.

The Prefectural Health Management Survey has the explicit aim of “resolving the health-related anxiety of Fukushima residents”. However, many mothers in the prefecture are voicing their concerns over the way the survey is being conducted. “At the examinations, we are not told any results at all. Some time later, all we receive is a letter saying whether or not a second exam is necessary. If we were to take our children for a thyroid examination at an ordinary clinic, the doctor would tell us immediately if there were any abnormality, such as a nodule, and the size of the nodule.” (Mother of two, resident in Fukushima city)

Lawyer Ido believes that the survey results reports themselves are also leading to distrust. “The interim report on survey results for the year ended March 31, 2013, has been released. According to this, 953 children required secondary examinations. Of these, 30 children were reported to have ‘malignancies or suspected malignancies’. But if we look at the fine print of the report, we find that of the 953 children who required secondary exams, only 594 children have actually undergone these exams. In other words, 359 children have yet to receive these secondary examinations. Statistically speaking, there are almost certainly going to be cases of ‘malignancies or suspected malignancies’ among those children”.

However, at the Review Committee, the results announcement gave the impression that all secondary examinations had been completed. What, in fact, is the likely number of children with thyroid cancer?

Ido says, “In the survey to date, a total of 43 children have been diagnosed with ‘malignancies or suspected malignancies’—13 in the year ended March 31, 2012, and 30 in the year ended March 31, 2013. Among those still to receive secondary exams, if the rate of thyroid caner is the same as those who have undergone the exams, my calculations estimate a total of 79 children. The survey for the current year ending March 31, 2014, covers another 160,000 children. So potentially I think around 100 children have already developed thyroid caner.”

One hundred—but that includes “suspected malignancies”, doesn’t it?

Ido explains, “Although some cases are presented as “suspected”, when cytological diagnosis has been carried out following the second exam—this is the basis for the final judgment on whether the cyst or nodule is malignant—in all but a single case cancer has been confirmed. Hence, even though the initial results may be stated as “suspected”, there is an extremely high probability that the final diagnosis will be caner. The 18 cases reported on August 20 are only those who have completed the cytological diagnosis”.

While it is shocking that 18 children have already been confirmed to have thyroid caner, it is likely that many times that number will also be diagnosed with cancer. How are the people of Fukushima reacting to this reality?

“Parents with a high awareness of the risks are taking it very seriously. They are saying things like, ‘My kids were in the clear this time, but who knows about the next exam?’ Just recently, there was a family who moved to Kobe (in western Japan). The father had been against moving, but he changed his mind when he realized the risk to his children of staying. But there are a lot of people who say. ‘It’s a worry, but what can you do?’ For those in their 50s or 60s, a lot just give up and say ‘It’s too late anyway’”. (Housewife, 50s, resident in Koriyama city)

The results announced on August 20 should have grabbed the headlines and stirred heated debate. In fact, the announcement received only minimal coverage in newspapers and on television. The news barely reached the general public. It seems that even worse news will be needed before people start paying attention.

This is an excerpt from the Proceedings of the 12th Prefectural Oversight Committee Meeting for Fukushima Health Management Survey, unofficially translated by the Department of International Cooperation, Radiation Medical Science Center of Fukushima Medical University. It is provided for information purposes only, and reliance should be placed on the original Japanese version of the proceedings.